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KELLY M NELSON DO
NPI 1720293749
Family Medicine in Coeur D Alene, ID

Active since May 12, 2007PECOS EnrolledAccepts Medicare Assignment
566 W PRAIRIE AVE, COEUR D ALENE, ID 83815(208) 625-5155(208) 625-5156 Get Directions Write a Review

NPPES record last updated: April 26, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 26, 2024, Oct 2, 2020, Oct 30, 2019 (3 updates tracked since 2019).

About Kelly M Nelson Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY M NELSON DO (NPI 1720293749) is an individual family medicine provider in Coeur D Alene, Idaho, licensed in Idaho (O1165) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS, is affiliated with Kootenai Health, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1720293749
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKELLY M NELSONCredential: DO
Location Address566 W PRAIRIE AVECoeur D Alene, ID 83815-7766
Mailing Address2003 Kootenai Health WayCoeur D Alene, ID 83814-6051 · (208) 625-5085 · Fax (208) 625-5731
Phone(208) 625-5155
Fax(208) 625-5156
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateMay 12, 2007
Last NPPES UpdateApril 26, 20243 updates tracked since enumeration
NPPES CertifiedApril 26, 2024
✔ NPI 1720293749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in ID · O1165
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
566 W PRAIRIE AVE, Coeur D Alene, ID 83815
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Moda Health Plan, Inc., Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly M Nelson Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8123191806
PECOS Enrollment IDI20191129000197
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Kelly Nelson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Kootenai Health, Inc.
3.4 mi
Psychiatry
2003 KOOTENAI HEALTH WAY
Coeur D Alene, ID 83814
  • Reassigned Medicare billing, Idaho enrollment
  • 472 clinicians in this Medicare group
NPI 1174661151 (208) 625-4000
Kootenai Health, Inc.
3.4 mi
Psychiatry
2003 KOOTENAI HEALTH WAY
Coeur D Alene, ID 83814
  • Reassigned Medicare billing, Idaho enrollment
  • 301 clinicians in this Medicare group
NPI 1174661151 (208) 625-4000
Multicare Health System
20 mi
Internal Medicine
15533 E BROADWAY AVE
Spokane Valley, WA 99037
  • Reassigned Medicare billing, Washington enrollment
  • 4,383 clinicians in this Medicare group
NPI 1336902345 (509) 530-4260

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
440 services234 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
263 services159 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
214 services214 patients
Transitional care management services for problem of at least moderate complexity 99495
Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
47 services40 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
30 services25 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
18 services18 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Kootenai Health

Acute Care Hospitals · Coeur D'alene, ID
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number130049
Location2003 Kootenai Health WayCoeur D'alene, ID 83814 · Kootenai County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83815 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers20 claims36 services$5.53 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
5 suppliers13 claims13 services$36.16 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
4 suppliers13 claims78 services$2.25 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KOOTENAI URGENT CARE LLC
Family Medicine
566 W PRAIRIE AVE
COEUR D ALENE, ID 83815
Kootenai County (208) 772-9110
MR. DOUGLAS SEAN LINFORD MD
Family Medicine
566 W PRAIRIE AVE
COEUR D ALENE, ID 83815
Kootenai County (208) 772-8263
KATIE VANCLEAVE DO
Obstetrics & Gynecology
566 W PRAIRIE AVE
COEUR D ALENE, ID 83815
Kootenai County (208) 625-4970

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Nelson's NPI number?

The NPI number for Kelly Nelson is 1720293749. It was assigned to this individual provider in the NPPES registry on May 12, 2007.

Where is Kelly Nelson located?

Kelly Nelson practices at 566 W Prairie Ave, Coeur D Alene, ID 83815. The listed phone number is (208) 625-5155.

What is Kelly Nelson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kelly Nelson enrolled in Medicare?

Yes. Kelly Nelson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kelly Nelson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Nelson reassigns Medicare benefits to 3 organizations: Kootenai Health, Inc. (Coeur D Alene, ID), Kootenai Health, Inc. (Coeur D Alene, ID) and Multicare Health System (Spokane Valley, WA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Nelson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Nelson accept?

Health plans from Ambetter Health, Moda Health Plan, Inc., Molina Healthcare, PacificSource Health Plans and Premera Blue Cross Blue Shield of Alaska and 1 other insurer list Kelly Nelson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kelly Nelson affiliated with any hospitals?

According to CMS data, Kelly Nelson is affiliated with Kootenai Health.

When was this NPI record last updated?

The NPPES record for Kelly Nelson was last updated on April 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.